Reverse total shoulder replacement surgery requires the patient to participate in their recovery. In this article, we are going to talk about some recovery goals and guidelines for reverse total shoulder replacement surgery.
Goals and Guidelines:
The first phase of therapy after reverse total shoulder replacement surgery is 6 weeks and is focused on active assisted range of motion exercises only. During this time, the patient may work on scapular protraction and retraction for strengthening but no strengthening exercises for deltoid or remaining rotator cuff (RC).
The patient is allowed to use the operative arm for waist level and midline activities such as personal hygiene care but is to do no lifting, pushing or pulling with the arm. For the first couple weeks, most patients are more comfortable sleeping in their sling and a recliner but they may move to a bed when comfortable.
The second phase of therapy is about 2 months and focuses on continued stretching and strengthening. The strengthening starts slowly and progresses to functional exercises. In many cases, the anterior cuff (subscapularis) and posterior cuff (teres minor) remain intact and can be strengthened to improve internal and external rotation function. Whether using bands or weights, the strengthening should not be painful and focus on a resistance with which the patient can perform 10-15 reps comfortably. Most patients are able to play a round of golf at 4 months postop and are released to more aggressive activities at that point but improvements in strength and function continue for up to 2 years.
